Depression an Aftershock of Traumatic Brain Injuries

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But it's the physical and cognitive impairments caused by traumatic brain injuries that are typically the focus of scientific research and treatment efforts. The injuries can be fatal, even weeks after they occur. Long term, more than half of seriously injured patients suffer from permanent cognitive impairment or physical disability.

Now, a new study, published in this week's Journal of the American Medical Association, is offering a comprehensive look at just how prevalent depression is among these patients. The study is the first to use a major sample, along with specific diagnostic criteria, to address rates of depression among patients following their injury.

Researchers, led by Dr. Charles Bombardier at the University of Washington, recruited 559 patients who were admitted to hospital for traumatic brain injuries. Study participants were tracked with routine phone calls for a year following discharge and surveyed using a nine-item depression diagnostic scale.

One month into the follow-ups, 53 percent of the participants met the diagnostic criteria for depression. After a year, 41 percent of participants with no history of depression before the injury had suffered a bout of depression. That's 7.9 times greater than the general population.

"The impact of depression following brain injury is so much greater than simply that diagnosis," Bombardier said at a press conference. "These people can't function well on a cognitive level, and they suffer anxiety and higher rates of suicide attempts."

Depressed study participants also suffered more anxiety and rated their health more poorly than those whose injuries didn't lead to depression.

Perhaps most worrisome is the rate of patients undergoing counseling or being prescribed antidepressant medication. Only 44 percent of depressed study participants reported receiving either during the 12-month study period.

"Unfortunately, major depression is under-treated," Bombardier said. "And we suspect, based on other primary-care literature, that these are conservative estimates of how many people are receiving adequate treatment."

The injuries have garnered recent attention for their prevalence among recent military veterans. Around one-third of those admitted to Washington, D.C.'s Walter Reed Army Medical Cewedding dressesnter between 2003 and 2005 were suffering from traumatic brain injuries, probably because of exposure to improvised explosive devices.

But civilians are also at risk. Simple falls account for 28 percent of such injuries in the U.S. each year. Contact sports like football, car accidents and even child abuse are also well-known causes.

One expert not affiliated with the study recommends ongoing evaluation for patients who've suffered traumatic brain injuries.

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But civilians are also at risk. Simple falls account for 28 percent of such injuries in the U.S. each year. Contact sports like football, car accidents and even child abuse are also well-known causes. One expert not affiliated with the study recommends ongoing evaluation for patients who've suffered traumatic brain injuries. Mary Hibbard, director of psychology at the Rusk Institute of Rehabilitation Medicine in New York City, says the study underscores how important it is for patients to be screened and treated for depression following a brain injury. "Brain injury is a lifelong issue," she told CNN. "Individuals with brain injury remain at risk for development of depression at any point after injury, so a periodic, routine screening every six months should be a standard of care." Filed under: Health

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